Stents no better than heart drugs in diabetics

By Julie Steenhuysen

CHICAGO (Reuters) - Diabetics with stable heart disease do just as well taking drugs alone as getting quick angioplasty or bypass surgery to open blocked heart arteries, U.S. researchers said on Sunday.

They said patients advised to have angioplasty and a heart stent to restore blood flow and ease chest pain could safely wait and give drugs a chance to work.

But those with more severe disease sent for more invasive heart bypass surgery might be able to avoid a future heart attack if they have the surgery right away.

The study also found no difference in heart risks between two strategies for treating type 2 diabetes -- increasing the amount of insulin or lowering the body's resistance to its own insulin with drugs such as either metformin or GlaxoSmithKline's Avandia, also known as rosiglitazone, which had been thought to raise the risk of heart attacks.

"If you have diabetes and heart disease such that a bypass surgery is a recommended procedure, you should have that early rather than delaying it," said Dr. Trevor Orchard of the University of Pittsburgh, whose study appears in the New England Journal of Medicine.

Orchard said the study, also being presented at the American Diabetes Association meeting in New Orleans, offers evidence on how best to treat people with both type 2 diabetes and heart disease. More than 65 percent of people with diabetes die from heart disease or stroke.

For GlaxoSmithKline, the study represents a positive sign that Avandia may be safer than earlier analyses had suggested.

But it may be another blow for stent makers such as Boston Scientific Corp and Johnson & Johnson, whose U.S. sales plummeted after a similar study two years ago showed stents were no better than drugs at preventing death and heart attacks in all types of heart patients.